An intriguing idea about cancer as an evolutionary disorder

George Johnson, author of a piece in theNY Times Sunday Review 01/05/14, has an unusual and fascinating take on cancer as an evolutionary adaptive response that gets out of control.He remarks that as we are exposed to more and more sophisticated medicine we do not succumb as we age as our parents or grandparents did. He suggests that adaptations in our genes can sometimes result in cancer. Furthermore, he theorizes that everyone will have cancer if they live long enough.

What are the implications for your end of life planning?If you or a loved one is stricken in advanced years with cancer, how will you decide what you want to do? if you are younger…middle aged for example, what would you decide?

There are many different valid responses to this dilemma. Here are two examples:

An 88 year old woman was diagnosed with cancer and elected to go through the surgery, radiation, and chemotherapy.

A physician diagnosed with terminal cancer at a much younger age decided not to treat the underlying disease and opted instead for comfort care and the best possible quality of life for the time remaining.

Many of us will have to make choices as to how much we want to fight a potentially fatal disease. Many things will contribute to our decision including age, financial resources, leaving loved ones, the diagnosis and the prognosis, and the burdens (and side effects) of chemotherapy, radiation, and surgery.

These decisions are well documented in the reality show, “Time of Death” referenced elsewhere in this blog. Some patients elected extensive treatment and others chose none at all. Of note was the introduction of Hospice and Palliative medicine in helping many of the subjects of this documentary deal with their illness.